The Impact of Workforce Turnover on the Sustainability of Evidence-Based Programs: A Critical Scoping Literature Review

Abstract

Background and Purpose Evidence-based programs (EBPs) are used throughout disciplines to integrate research into practice with the aim of facilitating positive outcomes at the individual or community level. Despite the widespread development and implementation of EBPs, many programs are not sustained beyond the initial implementation period due to many factors, including workforce turnover. The purpose of this study was to conduct a scoping review to examine and describe the impact of workforce turnover on the sustainability of EBPs and assess whether any recommendations for mitigating the impacts currently exist. Methods We searched 10 databases for articles that focused on an EBP and described an association between workforce turnover and the sustainment or sustainability of the program. A data abstraction tool was created to extract relevant information from each of the articles. A team of four graduate students applied the data abstraction tool to all included articles to create the dataset. Data was mapped and analyzed using the Program Sustainability Framework (PSF). Results and Discussion A total of 23 articles were included in this scoping review and mapped to the PSF. Twenty-two articles described impacts of workforce turnover and 15 articles proposed recommendations to address the impacts. Common impacts of workforce turnover identified by this review included increased need for training, loss of organizational knowledge, lack of EBP fidelity, and financial stress. Recommendations to address the impact of workforce turnover included affordable and alternative training modalities, the use of champions or volunteers, increasing program alignment with organizational goals, and generating diverse funding portfolios. Conclusion The sustainment of EBPs is critical in order to ensure and maintain the short- and long-term benefits of the EBP for all targeted participants or communities. Understanding the impacts of workforce turnover, a determinant of sustainability, can create awareness among EBP-implementing organizations and allow for proactive planning to increase the likelihood of program sustainability.